"Les soins qui suivent le patient" : Deployment of a patient portal for the management of chronic pain based on best practices


This innovation focuses on the implementation and evaluation of a telehomecare solution for people living with chronic pain (CP) which aims to reduce disability by increasing self-efficacy and self-management skills. This digital solution will enable the integration of technology into traditional models of care, while meeting the Ministry of Health’s vision for digital services and the objectives of the provincial strategic plan for chronic pain (2020-2025). The platform will integrate modules, developed by users and health professionals using cognitive neuroscience, namely:

  1. clinical information sharing,
  2. symptom monitoring,
  3. personalized action plans,
  4. self-management support and virtual care (e.g. cognitive behavioural therapy, physical activity),
  5. education, and
  6. case management.

In addition, the portal will integrate deep learning based on artificial intelligence to

  1. predict and prevent visits to clinic or emergency in the event of exacerbations;
  2. create a profile for each user that will use critical thresholds to program alerts and automatically adjust the user’s action plan.

The objectives of the evaluation of telehomecare are to:

  1. evaluate pre-implementation and post-implementation of the platform including degree of integration in clinical processes and barriers and facilitators to implementation;
  2. evaluate the impact of the platform on patients, providers and the health system;
  3. develop and disseminate an implementation guide to ensure sustainability and provincial scale-up of the platform.

The integration of a telehealth in care pathways will have direct and indirect benefits on decision-making, user empowerment and activation, health and social outcomes, quality of life, and access to care.